A new study published Monday in the journal Pediatrics suggests that foster children are being prescribed a powerful combination of antipsychosis drugs as frequently as some of the most mentally disabled kids on Medicaid.
The report is the first to investigate how often youngsters in foster homes are given two antipsychotic drugs at once, according to the the authors. The drugs are sometimes called major tranquilizers and they include Risperdal, Seroquel and Zyprexa, among others. They were developed to treat schizophrenia but are now used as for just about any psychiatric symptoms.
Susan dosReis, an associate professor in the University of Maryland School of Pharmacy and the lead author of the study, said, “The kids in foster care may come from bad homes, but they do not have the sort of complex medical issues that those in the disabled population do.”
Dr. dosReis and other experts say this implies that doctors are treating the behavior problems of foster children with the same powerful drugs used for schizophrenia and severe bipolar disorder. Dr. dosReis said, “We simply don’t have evidence to support this kind of use, especially in young children.”
Prior studies have revealed that foster children receive psychiatric medications at about twice the rate of children who are not in foster care. This contributes to an escalating concern among doctors and policy makers about high rates of psychiatric drug use in the foster care system, which is a government-financed program that provides temporary living arrangements for 400,000 to 500,000 children and teens.
The new study found that about two percent of foster children took one of the most powerful classes of drugs, antipsychotics, even though it is extremely rare for young children to have schizophrenia or bipolar disorder, the conditions for which these drugs are approved.
Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University (who did not contribute to the research) said, “It’s a significant and important finding, and it should prompt states to improve the quality of care in this area. ”
Researchers analyzed 2003 Medicaid records of 637,924 minors for the study. The minors were from an unidentified state and were either in foster care, getting disability benefits for a diagnosis, or in a program called Temporary Assistance for Needy Families. All three of these programs use Medicaid financing. The researchers discovered that 16,969 (about 3 percent) of the total, had received at least one prescription for an antipsychotic drug.
Among these, the foster children got more than one such prescription at the same time most often. They were treated with multiple drugs 9.2 percent of the time, as compared to 6.8 percent for the children on disability, and 2.5 percent for those in the needy families program.
The authors said antipsychotic drugs also cause rapid weight gain and increased risk of metabolic problems in many people, and that affect may be amplified by the use of two drugs at once.
The relatively high rates of these drug combinations in such a young group have led to a consortium of 16 states, working with Rutgers University, drawing up guidelines for the improvement of foster care and care of others dependent on state aid.